Sarcopenia as an independent associated factor for urinary incontinence in adults: a systematic review and...

This systematic review and meta-analysis aimed to evaluate the association between sarcopenia and urinary incontinence (UI) in adults by synthesizing evidence from observational studies.

A comprehensive literature search was conducted in MEDLINE, Cochrane Library, Embase, Web of Science, Scopus, and CINAHL from inception until April 20, 2026. Observational studies reporting the odds ratio (OR) with 95% confidence intervals (CI) for UI in adults with sarcopenia versus those without were included. Study selection, data extraction, and quality assessment were performed independently by two reviewers. Given anticipated clinical and methodological heterogeneity across the included studies (e.g., differences in sarcopenia diagnostic criteria, UI assessment tools, and study populations), we applied a random‑effects model. Subgroup analyses were conducted based on study design. Sensitivity and meta-regression analyses were performed to explore potential sources of heterogeneity.

Seven observational studies involving 45,273 participants were included. The pooled analysis demonstrated that sarcopenia was significantly associated with an higher odds of UI (OR = 1.92, 95% CI: 1.41-2.60, p < 0.001). Significant heterogeneity was observed (I² = 63.1%, p = 0.012), which indicates moderate between‑study variation, suggesting that the pooled estimate should be interpreted with caution and that the strength of the association may differ across study settings. In subgroup analysis by study design, the association remained significant in cross‑sectional studies (OR = 2.00, 95% CI: 1.39-2.86, p < 0.001) but was not statistically significant in the single prospective cohort study (OR = 1.70, 95% CI: 0.998-2.90, p = 0.051). Sensitivity and meta-regression analyses did not identify clear sources of the observed heterogeneity.

Sarcopenia is significantly associated with higher odds of urinary incontinence in adults. These findings highlight the potential importance of assessing and managing sarcopenia in individuals with or at risk for UI. Further high-quality prospective cohort studies are needed to strengthen causal inference.